红细胞分布宽度/白蛋白比值对重症社区获得性肺炎不良结局预测价值

Analysis of predictive value of red cell distribution width/albumin ratio on adverse outcome for patients with severe community⁃acquired pneumonia

目的 探讨红细胞分布宽度/白蛋白(RDW/ALB)比值对重症社区获得性肺炎(sCAP)不良结局的预测价值。方法 分析107例sCAP患者的临床资料,根据30 d预后情况分为预后不良组和预后良好组。采用单因素和多因素Logistic回归分析,揭示预后的影响因素。采用受试者特征工作(ROC)曲线分析RDW/ALB比值预测预后的能力。结果 sCAP患者预后不良组RDW/ALB比值的中位数显著高于预后良好组(P<0.05),RDW/ALB比值越高,30 d预后不良发生率越高(OR=1.155,95%CI:1.007~2.430,P<0.05)。计算RDW/ALB比值曲线下面积(AUC)为0.761(95%CI:0.665~0.857),高于肺炎严重程度指数(PSI)评分的0.740(95%CI:0.643~0.837)(P<0.05)。当RDW/ALB比值与PSI评分结合时,AUC值增加到0.817(95%CI:0.736~0.899),高于PSI评分或单独的RDW/ALB比值(P<0.05)。结论 RDW/ALB比值具有较好预测重症社区获得性肺炎不良结局的价值。

Objective To investigate the predictive value of red blood cell distribution width/albu⁃min ratio(RDW/ALB)on adverse outcome for patients with severe community⁃acquired pneumonia(sCAP).Methods Clinical data from 107 patients with sCAP were retrospectively analyzed and divided into two groups:a poor prognosis group and a good prognosis group based on their 30⁃day prognosis.Univariate and mul⁃tivariate logistic regression analyses was used to identify the prognostic factors.Receiver operating characteristic(ROC)curve was used to assess the predictive ability of the RDW/ALB ratio for prognosis.Results The medi⁃an RDW/ALB ratio of sCAP patients with a poor prognosis was significantly higher than that of the good progno⁃sis group(P<0.05).A higher RDW/ALB ratio was associated with a higher incidence of 30⁃day poor prognosis(OR=1.155,95%CI:1.007~2.430,P<0.05).Meanwhile,the area under the curve(AUC)of the RDW/ALB ratio was 0.761(95%CI:0.665~0.857),which was higher than the AUC of 0.740(95%CI:0.643~0.837)in the pneumonia severity index(PSI)(P<0.05).When the RDW/ALB ratio was combined with the PSI score,the AUC increased to 0.817(95%CI:0.736~0.899),which was higher than either the PSI score or RDW/ALB ratio alone(P<0.05).Conclusion The RDW/ALB ratio has great predictive value for postoperative adverse out⁃comes in patients with severe community⁃acquired pneumonia.